Foot disease such as minor irritation, rashes, calluses, corns, bunions and ingrown toe nails to more severe traumatic conditions such as heel spurs are endemic. Many of these conditions such as bunions are hereditary. However, all of these conditions are aggravated by abrasion or rubbing and many are solely attributable to irritation caused by abrasion. Many people suffer from skin irritation even when using the best made shoes or using shoe inserts such as arch supports.
Doctors of Medicine (M.D.) and of Podiatric Medicine (D.P.M.) are specially trained in the treatment of diseases of the feet. A sub-specialty, Sports Medicine, has recently been recognized. Though doctors who specialize in Sports Medicine treat all trauma related to athletics, many of the conditions they treat deal with the feet. Some of the most common problems include heel spurs, corns, bunions and calluses on the ball of the foot. Most of these traumas arise due to pressure from an underlying bone structure. There is also a large population of people who regularly run or play ball on hard unyielding surfaces which can cause or aggravate the above-described traumas. The usual therapy is surgical removal, sometimes followed or preceded by prescriptions of a biomechanical device, physiotherapy or topical or oral medication. Oral anti-inflammatory medicine can cause stomach upset and in some cases leads to inflammed or bleeding stomach ulcers.
One alternative to surgery is the use of a rigid, molded, shaped orthotic. These devices are designed to correct the angular relationships between the various segments of each foot resulting in more normal functioning of the feet and legs. The end result is intended to decrease or eliminate foot symptoms, corns and calluses. Orthotics that are formed of a rigid synthetic resin material are usually not comfortable and require a long period of adjustment. Furthermore, the rigid orthotic is expensive. Because of their high cost, most patients prefer to buy only one pair and use that single pair in the shoes that they are presently wearing. However the rigid orthotic may occupy so much volume of the wearer's shoe as to cause excessive pressure on the foot. The wearer may be required to buy larger shoes. Finally, though these devices do provide a more anatomically correct alignment of the foot and a reduction in pressure on stress points, they do not eliminate irritation caused by rubbing of the foot against the inner surface of the shoe, sport shoe, ski boot, etc.
The rigid, fixed orthotics are designed to correct various problems that may be congenital or have developed from wearing incorrect footwear. Problems requiring orthotic correction may also result from injuries as well from excessive standing, poor working conditions, sports activities, numerous diseases such as diabetes or the loss of padding on the bottom of the feet as the body ages.
Common methods of treatment have been developed to support the bottom of the feet, on their plantar aspect, to restore their normal functions while seeking to correct any symptomatic abnormalities without resorting to surgery.
In general, the footcare professional will make molds of the patient's feet. The mold is then analyzed and a prescription for a rigid or flexible fabricated orthotic having a fixed contour is sent to a laboratory that will custom mold the necessary corrective or accommodative orthotic. The molded orthotic is then sent to the footcare professional to be fitted in the patient's footwear.
If these molded orthotics need additional adjustments they either have to be returned to the fabrication facility for modification or the footcare professional has to maintain a workshop in order to be able to trim and adjust the orthotic units to suit the needs of the patient.
The molded orthotics, whether rigid or flexible, are made using special tools. The final product is a specially molded, rigid pad which provides the necessary foot contacting curvatures and contours. These pads are expensive to produce and require specialized molding equipment.
Once the fabricated orthotics have been molded, the patients are advised to wear their new orthotics only for a short time each day, until their feet get used to them. This "breaking-in" process may be too uncomfortable for the patient to bear and sometimes cause the patient to stop using the orthotic and/or seek alternative treatment.
In many cases, the patient will purchase widely advertised shoe inserts that will for a time seem to reduce pain and discomfort. These products generally fail to truly provide the necessary comfort or required correction of the underlying foot problems. Many experiences with fixed orthotics are often time consuming and painful for the patient and frustrating for the footcare provider.
It has been discovered that even with the best adjustment of the foot, the foot will still move slightly in the shoe, slipper or boot relative to the shoe's interior surface while the patent is walking or running. This movement or slippage is also caused by the molded orthotic not being the precise length of the shoe into which it is placed. This undesired foot movement will progressively lead to discomfort, irritation and then trauma.